Cardiovascular Flashcards
What accounts for the majority of cardio problems for children in developed countries?
Congenital heart disease
Name 3 genetic disorders associated with CHD?
Downs
Turner’s
DiGeorge
What are the CHD associations with Down’s, Turner’s and DiGeorge syndrome?
Downs - AV septal defect
Turners - Coarctation of the aorta
DiGeorge - Interrupted aortic arch
Name 2 teratogens associated with CHD
alcohol
lithium
What CHD defect is associated with alcohol?
AV septal defect
What infection is associated with CHD and what defect can it lead to?
Rubella
patent ductus arteriosus
What CHD defect is associated with maternal diabetes mellitus?
transposition of the great arteries
6 symptoms of CHD in young children
poor feeding cough dyspnoea sweating faltering growth recurrent chest infections
5 symptoms of CHD in older children
syncope palpitations SoB exercise intolerence Chest pain
5 major physical signs of CHD
cyanosis murmurs cardiac failure cardiogenic shock finger clubbing (rare)
What is central cyanosis and is it anything to worry about in children?
Blue lips and tongue
Always pathological
What is peripheral cyanosis and is it anything to worry about in children?
Blue hands/feet.
Can be normal in newborns with first 24 hours
How is central cyanosis due to CHD distinguished from that due to respiratory disease?
CHD - failure of the partial pressure of oxygen in the right radial artery to get above 15kPa after breathing 100% oxygen for 10 mins.
Is a diastolic murmur in a child anything to worry about?
Always pathological
5 features of likely innocent murmurs in children?
Asymptomatic child normal CV examination systolic or continuous no radiation variation with posture
What is the most common variety of CHD?
ventricular septal defect
What is rheumatic fever and what is it caused by?
abnormal immune response to streptococcal infection
What criteria is used for diagnosing rheumatic fever?
Jones criteria
What is the required criteria for diagnnosing rheumatic fever?
Evidence of streptococcal infection
throat swab or raised antistrepolysin
What are 5 major criteria for diagnosing rheumatic fever?
Polyarthritis (fleeting major joints) Erythema marginatum Subcutaneous nodules Carditis Chorea
What blood markers would be raised in someone with rheumatic fever?
ESR
CRP
While cell count
4 minor criteria for diagnosing rheumatic fever?
Fever
Arthralgia
Previous rheumatic fever
Prolonged PR interval
5 management steps for rheumatic fever
bed rest aspirin steriods diuretics and ACEi for heart failure antibiotics
When should infective endocarditis be suspected?
Any child with fever and significant cardiac murmur
Clinical features of infective endocarditis associate with the following causes: Bacteraemia Valvulitis immunological process embolic
Fever, malaise
cardiac and murmurs
glomerulonephritis
CNS abcesses and splinter haemorrhages
Lab diagnosis tools for suspected endocarditis?
Blood cultures x3 in first 24 hours of hospitalisation.
Cross sectional echo (cannot exclude only confirm)
What is the most common causative organism of infective endocarditis?
Streptococcus viridans
Mgmt of infective endocarditis
4-6 weeks of IV antibiotics
possible removal of infected implant
